title: High-dose vitamin D: helpful or harmful?
abstract: If the optimal serum 25(OH)D level for skeletal health is 30 ng/mL or greater, then vitamin D insufficiency is widespread, affecting about 75% of adults based on a recent survey of more than 20,000 Americans. However, after a comprehensive analysis of existing research studies, the Institute of Medicine recently concluded that nearly all individuals are vitamin D replete when their 25(OH)D levels are 20 ng/mL or greater. Furthermore, two recent publications challenge the belief that 25(OH)D levels greater than 30 ng/mL are optimal for bone health. In a randomized, placebo-controlled trial, high-dose, once-yearly vitamin D therapy increased the incidence of fractures and falls. The second study reported that high-dose vitamin D did not reduce levels of parathyroid hormone or bone resorption among adults with 25(OH)D levels less than 32 ng/mL at baseline. It is time to question whether serum 25(OH)D levels of 30 ng/mL or greater are necessary for all individuals.
authors.affiliation: Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Room 4124 MFCB, 1685 Highland Avenue, Madison, WI 53705-2281, USA. keh@medicine.wisc.edu
authors.forename: Karen E
authors.initials: KE
authors.lastname: Hansen
mesh_terms: D015519:Bone Density / Q000187:drug effects; D001862:Bone Resorption / Q000188:drug therapy; D002118:Calcium / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D050723:Fractures, Bone / Q000517:prevention & control; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D018673:Nutrition Policy; D016032:Randomized Controlled Trials as Topic; D014807:Vitamin D / Q000009:adverse effects* / Q000627:therapeutic use*
chemical_list: D014807:Vitamin D; D002118:Calcium